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Washington rates for HCPCS J1953

Injection, levetiracetam, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $15.00 / $166.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.08
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.06 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.05 / $0.15
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.07
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04